Compression stockings are specialized garments designed to promote healthy blood flow by exerting controlled pressure on the legs. This pressure is graduated, meaning it is strongest at the ankle and gradually decreases toward the knee or thigh. This assists the veins in pushing deoxygenated blood back toward the heart against gravity, preventing blood from pooling and reducing issues like swelling or deep vein thrombosis. Because of this tight, reinforced elasticity, the stockings are inherently difficult to apply. Proper application is important, as a twisted or bunched garment can constrict circulation rather than support it, potentially causing discomfort or skin damage.
Essential Preparation Before Application
The first step in application is preparing both the leg and the garment. It is advised to put on the stockings first thing in the morning when the legs are least swollen, which makes the fitting process easier. Swelling can occur quickly once a person begins standing or sitting upright, making a later application more challenging. The skin must be completely dry and free of lotions, oils, or moisturizers, as these increase friction and make the garment difficult to slide up the leg.
Before handling the material, inspect your hands and feet for potential snags or tears. Fingernails and toenails should be smooth and filed to prevent damaging the material. Remove any rings or jewelry that could catch on the fabric, as this can cause runs or tears, compromising the therapeutic pressure. A light dusting of talcum powder or cornstarch on the leg can help the stocking glide more easily, especially if the skin is naturally moist.
Step-by-Step Manual Application Technique
The most effective manual method involves turning the stocking mostly inside out to reduce the friction surface. Reach into the stocking to grasp the heel pocket, then pull the top of the garment down over your hand until the stocking is inside out. This technique concentrates the tightest part of the garment over the foot, which is the most difficult area to pass.
Next, slide your foot into the remaining toe portion of the stocking, ensuring the heel pocket is perfectly aligned with your actual heel. Once the foot is fully inserted and the heel is in place, begin the process of unrolling the stocking up the leg. Use the palms of your hands to grasp the folded material and pull it up in short, incremental sections.
Avoid pulling the stocking up by the top band or stretching the material excessively, as this can damage the elastic fibers and reduce the garment’s effectiveness. Continue this slow, rolling motion, distributing the fabric evenly over the calf and up the leg until the top band rests in its final position. For knee-high stockings, the top band should sit approximately two finger-widths below the crease of the knee to prevent constriction.
Utilizing Specialized Application Aids
When the manual technique proves too difficult due to limited mobility or hand strength, several specialized aids can simplify the process:
- Donning gloves, often made of rubber or a textured fabric, provide a superior grip on the slippery stocking material. These allow the user to pull and smooth the fabric with less force while simultaneously protecting the garment from fingernail snags.
- Metal or plastic stocking frames, often called donners or butlers, are useful for individuals who have trouble bending over. The stocking is loaded onto the frame, which holds the garment open and allows the user to simply slide their foot into the device, using long handles to pull the frame and the stocking up the leg.
- Slippery aids, such as silk or nylon liners, offer a temporary reduction in friction. These liners are worn over the foot, allowing the compression stocking to glide easily into place, and are then removed through the open toe of the stocking once the garment is fully on the leg.
Troubleshooting and Safe Removal
Once the stocking is applied, smooth out any wrinkles or bunched areas immediately. Bunches of fabric create localized areas of high pressure, which can impede circulation or cause painful indentations on the skin. Use your palms or donning gloves to gently smooth the fabric from the ankle upwards, ensuring the material lies flat against the skin.
If the stocking begins to roll down from the top band, it usually indicates the garment has been pulled too high or is the wrong size. It should not be folded over, as this creates a tourniquet effect. The safest course of action is to pull the stocking back down and reapply it correctly, or remove it and start over if it is severely twisted. For safe removal, the process is reversed by gently peeling the top of the stocking down, turning it inside out as you move toward the ankle. Slowly roll the garment down the leg and over the heel, avoiding harsh tugging on the top band. Compression stockings are typically removed at the end of the day, unless a healthcare provider advises otherwise.